Provider Demographics
NPI:1386814184
Name:LEY, FAITH ANN (PT)
Entity Type:Individual
Prefix:MISS
First Name:FAITH
Middle Name:ANN
Last Name:LEY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1810 N PERKINS RD
Mailing Address - Street 2:
Mailing Address - City:STILLWATER
Mailing Address - State:OK
Mailing Address - Zip Code:74075-2992
Mailing Address - Country:US
Mailing Address - Phone:405-624-6592
Mailing Address - Fax:405-624-6596
Practice Address - Street 1:1810 N PERKINS RD
Practice Address - Street 2:
Practice Address - City:STILLWATER
Practice Address - State:OK
Practice Address - Zip Code:74075-2992
Practice Address - Country:US
Practice Address - Phone:405-625-6592
Practice Address - Fax:405-624-6596
Is Sole Proprietor?:No
Enumeration Date:2008-03-07
Last Update Date:2008-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK757225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK757OtherPHYSICAL THERAPY